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DavidG

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Posted 10/26/2013 11:41 PM (GMT 0)
David,
I want to offer a sincere apology if I have ever offended you. I want to offer an olive branch of peace.

We don't have to agree on things we post but we have to co-exist here at HealingWell. The best I can say is the truth that I never had any conflicts of interest in the works I do for prostate cancer support, research, advocacy, lobbying (Though I can no longer do that as a paid government advisor) and I also never intended to indicate anything less than being of assistance to a fellow survivor. To no end do I want you to think I don't care about your situation or your well being.

What's it going to be? Can we post here in peace and in unison so that others can be helped by our support and knowledge?

Very sincerely...

Tony

Post Edited (TC-LasVegas) : 10/26/2013 5:47:37 PM (GMT-6)

Posted 10/27/2013 12:42 AM (GMT 0)
Tony eating out and my wife isn't amused at my phone use. Wasn't this an email though? :) I also have performance anxiety so might just email back.
Posted 10/27/2013 12:48 AM (GMT 0)
Enjoy your dinner.

I thought a public apology was appropriate and an offer. Take your time. An email response is fine with me. Together we can show how to resolve differences.

Peace.

Tony
Posted 10/27/2013 1:47 AM (GMT 0)
that was an awful dinner.

Absolutely no apology necessary. For what?

My concern is that over the course of 3 years I have seen several dozen negative posts of a highly partisan nature about the ACA and I don't see how this will do anything but cultivate that trend.

I appreciate the scope of helping cancer patients navigate their situations so as to benefit from the ACA which is what I think those organizations I linked can help to do.

I don't see how individual anecdotes here can help though as this was always a law about the have nots even at the expense of the haves.

I don't care what the individual politics here are as I post about and for cancer, not political ideologies. But in all honesty I participated in the process back in 07/08 because I believed in it so when I see partisan jabs, accurate or not, I do take it personally. I guess we'll see how long we can keep politics out of this. Let's hope it doesn't become divisive.

Last thing I'll say about it is that unfortunately as part of my job I have to let a lot of people go. The biggest concern is always medical coverage. It's a real issue for American families. I think this new law, whether these people have cancer or not, will make their reality easier than the alternative of Cobra which is always prohibitive for them.

I think a separate HW forum on the ACA and how it pertains to HW individuals is a good idea if you have experts on the ACA and if you keep politics out of it. I just don't see that happening based on 3 years of comments I've seen here so far. Good luck nevertheless.
Posted 10/27/2013 1:57 AM (GMT 0)
David did you respond the wrong thread here? I think you may have...

Tony
Posted 10/27/2013 2:28 AM (GMT 0)
no, it's the same issue on 3-5 threads at this point.
Posted 10/27/2013 3:23 AM (GMT 0)
David to be clear,
This is an unconditional offer of peace. I need your help. For what? For hope.

The ACA is a system I hope works. I was not against it's passage as long as it achieves the goal of getting folks who need healthcare while not hindering others healthcare in any way. I use the term "Just Sayin'" frequently. My very dear friend David Emerson, may he rest in peace, once told me it was his favorite way of stating the facts as he saw them without overtone. Nothing else intended. I have used it ever since. You may have not understood that because I don't think you knew him like I did.

I have posted many things I believe that you can agree with and only a few that you don't agree with. That's ok with me 100%. It's from you, and all here, that I can learn to improve as an advocate. Some of my messages you won't like but most you should like. I try to only state the facts, as I know them to be, when I post.

In the issue of screening for example. ODOT. Accurate information is vital. A lot of information is unavailable. The assumption that the more men you test the more lives you save is accurate to a point we cannot define today. In any case with that matter I struggle with it. I have lost a few friends in their 40's. I have a friend whom lost her son at age 36. She is a strong proponent of screening as early as possible. She and I get along fine with love and friendship in spite of our differences. Why can't we?

Today is a new day. Will you be willing to restart this online relationship with the hope that we can together better the lives of others?

Peace to you.

Tony
Posted 10/27/2013 3:32 AM (GMT 0)
Tony we are fine. I'm not at war. I haven't done "war" in years, life is too short. I was just trying, albeit poorly, to explain my thoughts on this.

I did not know David Emerson. I believe I read his blog a few times including the final post there by his wife if I am not mistaken.

Really don't want to get into the ODOT theme again, I think many of us here have said everything we had to say about that one and although not the intention of anyone it ended up being a very bitter and divisive theme for many of us. I fear the ACA thing has the potential to become just as divisive, hope not.

We get along fine, and all of us here do our best to help where we can. Some of us, like you, certainly do a whole lot more. This is getting to be a little weird :)
Posted 10/27/2013 3:52 AM (GMT 0)
Very well then.

If you need to, contact me when you want to clarify something I say.

Peace it is.

Tony
Posted 10/27/2013 4:09 AM (GMT 0)
...and God bless us, every one.

--Tiny Peter
Posted 10/27/2013 8:57 AM (GMT 0)
Davidg, not sure if it is still the case but when I was laid off in 2010 there was a huge federal subsidy that offset the high costs of COBRA that actually made my net insurance costs the next year or so be less than what I had been paying while employed.

Different story on my net insurance costs of course when that ran out and I had not turned 65 yet.

I empathize with what you are going through having to downsize, rightsize whatever the euphemism du jour is, but you pretty much have to ignore their personal situation and follow the keep me out of court guidelines (that factors in longevity) by ranking their performance top to bottom and drawing the line then getting HR approval that the result is not overly biased with respect to age, gender, ethnicity etc.

Having done my fair share of both laying people off and being laid off myself, I much prefer the latter, but as 142 said, that was before I had PCa where availability of health insurance is so key.

Even better than those 2 false choices is my current one, being "retired" (sounds so much better than Unemployed and so old no one wants to hire you) and on Medicare, so not directly affected by work life balance or ACA.

I empathize with you younger guys with PCa that have to bear the huge costs, monetarily, physically and emotionally, and still wear your game face at work.

LupronJim
Posted 10/27/2013 3:59 PM (GMT 0)
davidg,
As Churchill once said, if you are young and not a liberal you don't have a heart. If you are old and not a conservative you don't have a brain. Perhaps there is a conversion coming somewhere in your future??

JT
Posted 10/27/2013 4:21 PM (GMT 0)
John, the conservatives Churchil was talking about were not in any way similar in beliefs to modern day American conservatives, at least a very large portion of the "new" breed.
Posted 10/27/2013 4:33 PM (GMT 0)
John T,

We'll have to check back on him in another 20 years. In the meanwhile, try to cut him some slack for being young and excitable.
Posted 10/27/2013 5:06 PM (GMT 0)
i'd be the first in my lineage although I do have bonafide fascists from the Italian side. BUt even those went into the war fascists and came out of it communists.
Posted 10/27/2013 10:18 PM (GMT 0)
Circle de politique, extrêmes meeting at the end=tyranny. Btw If you wait till you get even older, you will change again, arguably. I have anyway. If this post is the tipping point to never never land feel free to delete, Herr Moderator. lol At least it was just a french word and not a french…, er ah, never mind.
Posted 10/28/2013 12:36 AM (GMT 0)
I think I am late to this party, I have no idea what this thread is all about but since David mentioned layoff, I just want to add that the company that I work for is being sold and the transaction will be concluded on Dec 6th. All 230 employees will need to secure their own health insurance as the new employer does not provide it. Cobra, if available, will be quite costly. ACA is a viable alternative. I am glad it is available as I am still on this PCa journey and would have difficult time finding a provider. Cobra, if available, would cost me $3,600 per month plus 3% (me and my wife). Covered California will cost me about $1,650 for a comparable plan (platinum).
Posted 10/28/2013 2:03 AM (GMT 0)
akai,
The one thing that is certain ~ no insurance company can deny you coverage because you have a pre-existing condition. That IS included in the ACA law whether you go with an ACA state exchange or another private option. They cannot deny anyone for pre-existing cancer or illness of any nature. They face very stiff fines and even prosecution.

Tony

Post Edited (TC-LasVegas) : 10/27/2013 8:07:21 PM (GMT-6)

Posted 10/28/2013 6:55 PM (GMT 0)
I may be wrong, but I think the COBRA subsidies ended earlier this year, based on conversation with someone who was losing them.
Posted 10/28/2013 7:07 PM (GMT 0)
As I understand it the correct is "it depends". COBRA is not going away and there may be reasons for a patients to pay it. Whatever plan exists may have formulary, providers, or reasons that a plan purchased does not provide in the same way. ACA does not assure physician access, or prescription benefits will remain the same. That will depend on what plan is selected (Bronze, Silver, Gold, Platinum). What available physicians you may want to have may require COBRA of a different carrier within the exchange. Here is a statement I saw and it is an interesting question:

What Will Happen to COBRA in 2014?

Many have asked how the Affordable Care Act will impact COBRA continuation coverage. While the law has no direct impact to COBRA, the indirect effects may render COBRA meaningless. COBRA was originally intended to bridge coverage for employees who lose their job (or lose health coverage through their job). This was necessary because individual policies were (and are) expensive and quite often imposed pre-existing condition exclusions. The Affordable Care Act, however, is intended to de-link employment and health care. It does this through (1) prohibiting pre-existing condition exclusions, and (2) creating state exchanges where coverage will theoretically be available to individuals at affordable rates. So starting in 2014, individuals who lose employer-provided coverage will have the choice of either purchasing COBRA coverage or purchasing coverage through the exchanges. While COBRA only allows individuals to elect the coverage in which they were enrolled on the date of the qualifying event, the exchanges will offer a range of options (bronze, silver, gold and platinum coverage levels). It remains to be seen whether coverage through the exchanges will be affordable.
If it is, employees may be much less likely to elect COBRA continuation coverage. So, COBRA may still exist on the books, but it will likely be less frequently elected by individuals experiencing a qualifying event.

Tony
Posted 10/28/2013 7:14 PM (GMT 0)
I guess in short, while you cannot be denied services based on pre-existing conditions ~ you may have to change doctors to continue that service ~ unless you pay the COBRA.

But COBRA is not going away, and it could still be a good option. Here's another example. COBRA could cost 1500.00 dollars to maintain current coverage. If a patient has full coverage for say Zytiga ~ with no co-pay, then switching to an ACA bronze would not deny the service, but the co-pay could be 2000.00 per month plus the Bronze plan payment.

I don't know this for sure, but it could very well be the lesser evil with a high deductible plan. Many plans from employers have a deductible and if that deductible has been met, it may be better to keep it under COBRA since a new plan restarts the deductible clock and until it is met the out of pocket expense can be higher.

I don not think I have seen anything in the ACA that addresses this. It may be that it needs to be legislated. But do not take my work for it ~ contact the state exchange, the ACA hotline, or even the employer human resources advocate.

Tony
Posted 10/28/2013 7:58 PM (GMT 0)
COBRA isn't a permanent solution. It's also so expensive it's scary to your average person just being laid off. I believe COBRA is only viable for a set amount of time. I could be wrong but that is how I recall our HR training me on it.
Posted 10/28/2013 8:05 PM (GMT 0)
"The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end."
www.dol.gov/dol/topic/health-plans/cobra.htm
Posted 10/28/2013 9:38 PM (GMT 0)
David,
You are right it is not a permanent solution but it can still be a better option for some than ACA. At least until it runs our or the deductible clock runs out. It really will depend on each case.

I think it may go away in due time however. That could be a pitfall of ACA that simply wasn't in the bill. We'll have to wait and see. It would be a shame to see COBRA go away if it was a best option.

Tony
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